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Related Experiment Videos

Venous duplex scanning for unilateral symptoms: when do we need a contralateral evaluation?

N Miller1, D Obrand, L Tousignant

  • 1Department of Surgery, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Canada.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|March 31, 1998
PubMed
Summary

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Bilateral duplex scanning (DS) is often unnecessary for unilateral deep vein thrombosis (DVT) symptoms. Only perform bilateral DS in specific high-risk cases, such as recent joint surgery or malignancy, to optimize DVT diagnosis.

Area of Science:

  • Vascular Medicine
  • Diagnostic Imaging
  • Thrombosis Research

Background:

  • Deep vein thrombosis (DVT) diagnosis typically involves imaging of symptomatic limbs.
  • The utility of routine bilateral imaging in unilateral DVT presentation requires clarification.

Purpose of the Study:

  • To determine the necessity of bilateral duplex scanning (DS) in patients presenting with unilateral symptoms suggestive of acute DVT.
  • To identify specific patient subgroups who may benefit from bilateral DS.

Main Methods:

  • A prospective study involving 1,161 consecutive patients with unilateral leg pain or swelling was conducted.
  • Bilateral DS was performed on all participants, with demographic and DVT risk factor data collected.

Main Results:

Related Experiment Videos

  • Acute DVT was diagnosed in 22% of patients (250/1161).
  • Thrombus was unilateral in 80% and bilateral in 15% of DVT cases.
  • Contralateral findings did not alter management in any patient with bilateral thrombus.

Conclusions:

  • Recommend DS of the symptomatic extremity only for unilateral DVT symptoms.
  • Bilateral examination is indicated for patients with normal duplex findings in the symptomatic limb after recent joint surgery, or with advanced malignancy or hypercoagulability.
  • Bilateral DS is estimated to be required in approximately 11% of unilateral DVT cases.